Active NPI
Jenney Lu, NP
- Gerontology Nurse Practitioner
- Fort Belvoir, VA
National Provider Identifier
1063240950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 35030229
- Practice address
- 9300 Dewitt Loop
Fort Belvoir, VA 22060-5285 - Phone
- (571) 231-3224
- NPI assigned
- Jul 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 35030229 | CA | Primary |
Addresses
Primary practice location
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Mailing address
2455 Mandeville LN Apt 1212
Alexandria, VA 22314-6154
Phone (850) 346-1390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260316002043 | CA | Order and Referring Only - Nurse Practitioner | 8123501384 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35030229 | CA | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1063240950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2455 MANDEVILLE LN APT 1212",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223146154",
"telephone_number": "850-346-1390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220605285",
"telephone_number": "571-231-3224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LU",
"first_name": "JENNEY",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-23",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "35030229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.